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Anesth Analg 2004;99:350-352
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000132996.12248.B0

CARDIOVASCULAR ANESTHESIA

Postoperative Death in a Patient with Unrecognized Arrhythmogenic Right Ventricular Dysplasia Syndrome

Khay-Wee Toh, FRCA*, Kasinathan Nadesan, FRCPath{dagger}, Ming Yao Sie, FRCA*, Raja Vijeyasingam, FRCS{ddagger}, and Patrick Seow Koon Tan, FRCA*

Departments of *Anesthesiology, {dagger}Pathology, and {ddagger}Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Address correspondence and reprint requests to Khay-Wee Toh, FRCA, 27, Jalan Burhanuddin Helmi, Taman Tun Dr. Ismail, 60000 Kuala Lumpur, West Malaysia. Address e-mail to tohkhaywee{at}hotmail.com

Arrhythmogenic right ventricular dysplasia is an inherited disease causing fatty replacement of heart tissue. This disease often presents as T-wave inversion in the anterior leads of the electrocardiogram (ECG) with life-threatening ventricular arrhythmias. In older patients, progressive right and left ventricular failure can develop. This is a case report of postoperative death occurring in a 59-yr-old woman with undiagnosed arrhythmogenic right ventricular dysplasia after hepatic cystectomy. The patient had T-wave inversion in the inferior ECG leads and no history of arrhythmias. During general anesthesia, cardiovascular collapse occurred in the absence of arrhythmias that was unresponsive to resuscitation.

IMPLICATIONS: Arrhythmogenic right ventricular dysplasia (ARVD) is an inherited disease of the heart resulting in life-threatening arrhythmias and heart failure. The authors describe the case of a 59-yr-old female patient with undiagnosed ARVD. During general anesthesia, cardiovascular collapse unresponsive to resuscitation occurred in the absence of arrhythmias.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2004 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.